A parade of witnesses pleaded with members of an Iowa Senate Human Resources subcommittee to approve Senate File 71, a Medicaid expansion bill with 24 Democratic sponsors. More than a dozen people supported the legislation, saying it’s desperately needed. No one spoke against it.

No action was taken Monday, and a second hearing is planned in two weeks, said Iowa Senate President Pam Jochum, D-Dubuque, who chairs the subcommittee. The full Iowa Senate will likely approve the legislation sometime in the next two months, according to Democratic lawmakers, but the Republican-led House is not expected to consider it.

Iowa currently has about 450,000 people participating in Medicaid, a state-federal health insurance program, and tens of thousands of additional Iowans would be enrolled under President Barack Obama’s health care plan. Federal officials would pay Iowa’s full costs for the additional participants the first three years, and up to 90 percent in later years.

But Branstad opposes the expansion, saying he fears that the federal government, wrestling to contain massive deficits, would stick the state with huge expenses in the future.

In Senate testimony on Monday, low-income Iowans and advocates told heart-wrenching stories of problems caused by lack of health insurance.

Lou Ann Burkle of Des Moines explained how her daughter, who suffers from mental illness, could no longer be enrolled on Medicaid last year after she turned 21. Her only option is IowaCare, a state government program that offers limited services for people not eligible for Medicaid.

“Bottom line is — my daughter is overwhelmed, confused and mute,” Burkle said.

“Today is her birthday. She is 22 years old and lost in the system. Our daughter needs help. She needs the safety net of Medicaid.”

Holly Sells of Des Moines said she and her husband both work full time, but neither has jobs that offer health insurance.

“I love Iowa. It is a great place to live and people are wonderful,” Sells said. “But to not have access to the doctor is serious.”

Dr. Richard Deming, medical director of Mercy Cancer Center in Des Moines, said the expansion of Medicaid is a matter of human dignity and social justice.

One in two men in Iowa and one in three women in Iowa will be diagnosed with cancer in their lifetimes, Deming said. Prevention and early detection are crucial, but when people lack health insurance, it’s less likely their cancer will be detected in the early stages, he explained.

Teresa Bomhoff of Des Moines echoed the doctor’s sentiments, telling of a dear friend who knew that she had a predisposition to ovarian cancer, but didn’t have health insurance. When her friend’s cancer was detected, it was too late.

“She died way too early,” Bomhoff said.

Others spoke on behalf of formal groups, including the Iowa Human Needs Advocates, a coalition of church, labor, advocacy and other organizations. The group said expanding Medicaid would increase health care access, secure hospital finances and strengthen Iowa’s economy.

In addition, a failure to expand Medicaid would delay implementation and perhaps seriously damage efforts already under way to redesign the state’s system for serving mentally ill and mentally disabled Iowans, the advocacy group said.